While most people assume that addiction counselling is provided at an addiction treatment program, many don’t realize that drug rehabilitation treatment often provides counselling that focuses on other life domains impacted by addiction. For example, addiction impacts relationships, mental health, spirituality, our careers, and our financial standing. As a result, treatment has expanded its focus from treating the addiction to treating the whole person. This is sometimes referred to as the Biopsychosocial¹ approach to treatment.
(1) Note: The Biopsychosocial model evaluates and treats the physical, psychological, social, and spiritual symptoms of substance use and related disorders. For more information see the Biopsychosocial section.
Addiction Counselling Starts with a Conversation
Although counselling takes many forms, it is essentially a conversation between a client and a trained professional that is intended to help the client make sense of his life in a new way. This shift in how a client makes sense of his life provides insight into why he uses substances and gives him a roadmap for recovery.
Addiction COUNSELLING can be One-On-One or in Groups
Individuals with addictions often consider their problems unique and, therefore, prefer to speak privately with their counsellor. However, clients are frequently surprised to learn that most addiction counselling in residential treatment tends to be provided in a group setting. Groups are recognized as an effective method of breaking patterns of isolation which is a common symptom of addiction. During group counselling, clients have the opportunity to examine their thoughts, feelings and behaviours through sharing, listening and receiving feedback from their peers. In a group setting, clients also learn to develop important social skills.
Individual counselling, however, is still a necessary component of a comprehensive addiction treatment program. Clients may prefer to confide with their counselor on “taboo” topics such as sexual abuse, thoughts of suicide, and grief and loss. Clients may simply not be ready to share these traumatic episodes with their peer group. Moreover, individual addiction counselling is a necessary step in developing an individualized treatment plan.
Sunshine Coast Health Center provides a combination of both group and individual counselling.
The Weekly Treatment Schedule provides an outline of group activities, including group counselling, at Sunshine Coast Health Center.
There is More Than One Approach to Addiction Counselling
Theories abound to the actual cause of drug and alcohol addiction. The medical community, for example, typically considers addiction to be a brain disease while many psychologists believe that addiction is a learned behaviour. Far from just an intellectual exercise, determining the theory that a facility embraces is crucial because, ultimately, theory determines what type of therapy a client will encounter during treatment. This section introduces the most commonly found treatment models with additional information on how Sunshine Coast Health Center has integrated these models into its clinical program:
Meaning Centred Models — Meaning models have arisen mainly from psychiatrist Viktor Frankl’s statement that addiction is a response to living a life that has little personal meaning. Treatment consists of not only helping clients overcome barriers to a good life, such as depression or anxiety, but also to helping them discover what they would need to do to make them feel comfortable, energized, and fulfilled. Treatment at Sunshine Coast incorporates different models of treatment under the umbrella idea that the key to recovery is living a meaningful life.
Cognitive-Behavioral Models — By far, the most researched and written about model in understanding and treating addiction is the cognitive-behavioral model. This is the mainstream scientific psychology model. It argues that addiction is a result of destructive thinking and behavior. Treatment consists of discovering the faulty thinking that led to addiction, learning new coping skills to deal with anger or depression or anxiety, and learning how to create environmental conditions that aid recovery. Sunshine Coast uses cognitive-behavioral strategies and techniques, particularly in relapse prevention material.
Narrative Models — A relatively new model for understanding and treating addiction, narrative models argue that the “story” a client tells himself of who he is and how he fits in the world is creating unnecessary suffering for him. In effect, he is not in control of his life and is not being true to what is important to him. Therapy consists of helping the client appreciate that his way of making sense of his life no longer is working for him and that he needs a new way of understanding himself and his world. Because the new narrative matches his values, he is able to live a life that is true to himself. Narrative therapy plays a large role in the program at Sunshine Coast Health Center.
Disease Models — The modern disease model argues that the drug “hijacks” the user’s brain, leaving him or her powerless to make healthy choices. Addiction, which has a genetic predisposition, is strictly a matter of the drug interacting with chemical processes in the brain. The treatment goal is total abstinence, and treatment is targeted toward maintaining abstinence, such as learning how to deal with cravings. While Sunshine Coast accepts that there is a neurobiological component to addiction, it rejects an exclusive focus on the brain. Instead, Sunshine Coast Health Center interprets addiction within a bio-psycho-social-spiritual framework.
Minnesota Models — This is the most prevalent form of treatment in Canada and the United States, with at least 90 percent of programs using some form of the model. The model has its origins in the 1950s, borrowing the 12-step program of Alcoholics Anonymous and adding in medicine and behaviorist psychology. A new form of the model was publicized in 2000, which brought it more in line with scientific psychology; however, most current programs use the older model. The model considers addiction as a disease. Treatment consists of providing clients with a measure of physical and emotional stability (usually through medical and behavioral techniques). A key component is to introduce clients to the 12-step program, because the model leaves the agent of change to the 12-step program, and clients are expected to attend 12-step meetings after treatment. The meaning-centered model utilized at Sunshine Coast Health Center provides a psychological framework to understand the 12-step program. However, it does not accept the behaviorist practices and psychological theory of the Minnesota Model. Furthermore, Sunshine Coast does not accept much of the Minnesota’s Model’s interpretation of the 12-steps. Rather, our interpretation of the 12-steps is based on scholarly studies of the spiritual aspects of addiction as emphasized by Bill Wilson, the founder of AA.
Family Systems Models — A relatively new approach, family systems does not see the addict as a single entity, but rather as a part of the family “system.” While not denying that a single individual can be addicted, family systems prefers to interpret addiction as a phenomenon that arises to counter dysfunction in the family. More modern versions of the model emphasize that addiction reorganizes the family system in a way that the addicted person (the “identified patient”) becomes the focal point of the family. Sunshine Coast Health Center uses family systems approaches in its family program but under its umbrella approach of helping families live personally meaningful lives. We use family systems theory in family program which looks at the client within the larger family system. With a strength-focused language we examine patterns, dynamics, alliances, boundaries, etc. to help clients as well as families grow into the potential of their healthiest and most satisfying relationships (see also II. Relationship Counselling below).
Motivational Models — This model interprets addiction as a matter of motivation. Motivational theory is very complicated and includes neurobiology, as well as psychological and social components. According to motivational theory, the addict’s problem is pronounced motivation for using drugs and a diminished capacity for self-regulation. Treatment recognizes that recovery is a process and clients early in recovery are often undecided about whether they want to stop using drugs or alcohol. This is considered normal and therapists work with clients to help them develop “intrinsic” motivation to terminate their addiction. Sunshine Coast Health Center agrees with Motivational models that recovery is a process and often uses motivational techniques to help clients progress through the stages of recovery.
Solution-Focused Models — This therapy really doesn’t care what addiction is or where it came from. This model refuses to dwell on problems that the client brings into counselling—marital, health, financial, vocational, lifestyle. Its focus is on solutions. Solution-focused models are only concerned with the present and the future; exploring the client’s past, which so many therapies demand, is not necessary to help a client change behaviors. Treatment consists of emphasizing the client’s strengths and resources to overcome specific problems that have pushed him or her into treatment. Sunshine Coast Health Center uses many techniques of Solution-Focused Therapy; however, unlike Solution-Focused Therapy, Sunshine Coast pays attention to the bio-psycho-social-spiritual roots of the addiction which includes exploring a client’s past.
Harm Reduction Models — Originating in Europe, this model focuses on helping clients reduce the harm that drugs have caused them physically, financially, socially, and so on. In North America, harm reduction is usually associated with safe-injection sites or providing substitute drugs such as methadone. It assumes that addiction will always be with us, so the best approach is to ease the suffering of the addict, the family, and the community. Sunshine Coast Health Center is an abstinence-based program because it believes that treatment should do more than merely reduce harm to clients, families, and communities. Sunshine Coast is more positive and uplifting because it argues that clients have the potential to live with a sense of purpose and connection to others
Families and significant others are considered such an important part of the addiction program at Sunshine Coast that we have a full-time director of clinical and family services. Clients who have grown by challenging themselves in treatment also have an opportunity to work out the deeper communication and relationship dynamics with loved ones in their lives.
II.1. Family Counselling
Family counselling is based on the idea that a family’s patterns of behavior influences the addicted individual (and vice versa) and therefore needs to be a part of a client’s treatment plan. Marriage and family therapists treat a wide range of serious clinical problems including: depression, marital problems, anxiety, individual psychological problems, and child-parent problems *.
During the family & couples program at Sunshine Coast, partners and families work together to learn about the family dynamics of addiction as they explore healthier ways to respond to stress, heal from emotional burn-out, and learn how to support the people they love in recovery while also completing their own healing.
Sunshine Coast Health Center provides family counselling during the first three days of the Family & Couples Program. For more information refer to the American Association for Marriage and Family Therapy
Couples counselling (also known as marriage therapy) is defined * as a treatment designed to improve problems of married, common law or same-sex couples. Various psychodynamic, sexual, ethical, and economic aspects of marriage are considered. Husband and wife can work with the counsellor individually or together. Couples counselling is a broader term for marriage counselling as it encompasses unmarried or same-sex couples.
Sunshine Coast Health Center offers couples counselling as part of the family & couples program. During couples day, individuals in recovery and their partners explore how to overcome resentments while also learning about five skills for rebuilding healthy relationships: building trust, healing resentments, enhancing intimacy, communicating effectively and working together as a team. Couples day is conveniently scheduled on the Monday immediately following family program.
For more general information on couples and family therapy see the Help for Families and Partners section.
(*) Source: American Psychiatric Glossary, Sixth Edition, 1988, page 96
III.1. Mental Health Counselling
Mental health counselling is an important part of our drug and alcohol treatment program since the prevalence of clients having both addiction and mental illness (also known as concurrent disorder, co-occurring disorder or dual diagnosis). Mental health counselling covers many disorders including mood disorders (depression, bi-polar), anxiety disorders (panic, social phobias, obsessive-compulsive, post traumatic stress1), sexual disorders, somatoform disorders (unexplained physical pain), sleep disorders, eating disorder, impulse control disorders, schizophrenia2, cognitive disorders (delirium, dementia) and personality disorders.
Sunshine Coast Health Center is an approved provider of Co-Morbid 3 Operational Stress Injury (OSI)/Substance Use Disorder treatment for Canadian Forces and Veterans Affairs Canada.
Mental health counselling is not to be confused with mental health assessments which are the process of diagnosing the existence of mental health problems. Only a doctoral-level psychologist and psychiatrist are qualified to provide mental health assessments. For more information on assessment services offered at Sunshine Coast Health Center visit the Assessment Services section.
(1) Note: Post-traumatic stress is defined as an anxiety disorder that develops after a severe traumatic event or experience (Source: psyweb.com)
(2) Note: Schizophrenia is a mental disorder characterized by delusions, hallucinations, disturbances in thinking and withdrawal from social activity (Source: Schizophrenia Society of Canada)
(3) Note: Canadian Forces and Veterans Affairs Canada define the term “Co-Morbid” as having both addiction and operational stress injury at the same time.
Spirituality counselling (also known as pastoral counselling) is defined ¹ as a unique form of psychotherapy which uses spiritual resources as well as psychological understanding for healing and growth.
Our treatment center includes weekly spirituality group education as a way to promote the importance of spirituality ² as part of our Biopsychosocial approach to recovery.
For an additional fee, one-on-one spirituality counselling is also available. Contact our Admissions department for details.
(2) Note: Spirituality is often confused with religion. When religion is emphasized, this is known as faith-based counselling which would include Christian counselling. Although spirituality counselors may openly acknowledge their own religious faith, heritage, and values, they are trained to be objective and empathetic in relating to the client’s racial, religious, ethnic, or cultural memberships and preferences.
Vocational counselling is an important part of our addiction program, not only for our younger clientele but older clients who are experiencing career stagnation or considering a new career after retirement.
Some of the questions clients considering a new career may ask include:
- What can I do?
- What job/career would bring me the most satisfaction?
- Which job/career would be the best fit for me?
- Would I be successful at the career/vocational training or post-graduate education I am considering?
In conjunction with the Career Profile software program, which matches a client’s aptitudes and interest patterns to the National Occupation Classification of all the occupations and jobs in Canada, the GATB and CWPI are extremely helpful in answering common career-related questions.
Note: additional fees will be applied for vocational counselling.
Although personal finances are often a problem for people with addictions to drugs and alcohol, credit counselling (also known as debt counselling) is more commonly provided with gambling treatment. Typically, substance abuse treatment centers will recommend credit counselling for clients as part of a client’s discharge plan.
For assistance in locating credit counselling please contact Sunshine Coast Health Center Admissions toll-free at 1-866-487-9010 or visit Credit Counselling Canada for a list of credit counselling agencies across Canada.